Individual
PAUL GIOVANNI AYALA RAMOS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
NEMT
Contact information
Practice address
1195 S 3RD W APT 1, MOUNTAIN HOME, ID 83647-3447
(208) 598-1004
Mailing address
1195 S 3RD W APT 1, MOUNTAIN HOME, ID 83647-3447
(208) 598-1004
Taxonomy
Speciality
Code
Description
License number
State
172A00000X
Driver
Primary
AD009236C
ID
Other
Enumeration date
08/06/2022
Last updated
08/06/2022
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